Denture stomatitis — ORE Part 1 MCQ

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EasyRestorative DentistryDenture stomatitisORE Part 1

A 71-year-old complete denture wearer presents with a painless erythematous palate corresponding to the upper denture-bearing area. She sleeps in the denture and cleans it irregularly. There are no wipeable plaques and no ulceration. What is the most likely diagnosis?

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Correct answer: E — Denture stomatitis

The correct answer is E (Denture stomatitis). Denture stomatitis is characterized by painless erythema of the oral mucosa in direct contact with a denture, typically caused by polymicrobial biofilm accumulation. The absence of wipeable plaques rules out pseudomembranous candidiasis (thrush). The lack of ulceration excludes traumatic ulceration and herpetic stomatitis (which present with painful vesicles and erosions). Erythroplakia is a potentially malignant red patch unrelated to denture wearing. Pemphigus vulgaris is an autoimmune blistering disease presenting with painful erosions and oral involvement preceded by skin manifestations. The clinical context—aged denture wearer, poor denture hygiene, nocturnal wear—combined with painless erythema confined to the denture-bearing area, is pathognomonic for denture stomatitis, most likely Newton's Type II (diffuse erythema).

Reference: Epidemiology and etiology of denture stomatitis (PubMed 21463383, 2011); Management of Chronic Atrophic Candidiasis (PMC9967389, 2023); SDCEP Oral Ulceration guidance (madp.sdcep.org.uk), https://pubmed.ncbi.nlm.nih.gov/21463383/